NPI Code Details Logo

NPI 1649165333

NPI 1649165333 : M&M NP, INC. : DIAMOND BAR, CA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1649165333
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    M&M NP, INC. 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    06/11/2025
-----------------------------------------------------
    Last Update Date     |    06/11/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    1505 KIOWA CREST DR 
-----------------------------------------------------
    City                 |    DIAMOND BAR
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    91765-3918
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    661-877-1001
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    1505 KIOWA CREST DR 
-----------------------------------------------------
    City                 |    DIAMOND BAR
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    91765-3918
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    661-877-1001
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    DIRECTOR
-----------------------------------------------------
    Name                 |     CYNTHIA  INES 
-----------------------------------------------------
    Credential           |    NP
-----------------------------------------------------
    Telephone            |    661-877-1001
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    261QA1903X
-----------------------------------------------------
    Taxonomy Name        |    Ambulatory Surgical Clinic/Center
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.